Objective: To discuss the effect of pericardial devascularization plus gastric fundus transaction in advance schistosomiasis patients with portal hypertension.
Methods: Thirty-six advanced schistosomiasis patients with portal hypertension treated with devascularization plus gastric fundus transaction (a portal hypertension group), as well as 10 patients treated with modified Sugiura operation (a modified Sugiura operation group) in the Third People's Hospital of Yangxin County since 2006 were chosen as the observation objects, and the clinical effects of the two groups were observed and compared.
Results: The operation time, indwelling time of stomach tube, time to taking food after operation, drainage tube removal time of the portal hypertension group were all shorten than those of the modified Sugiura operation group (all P＜0.05). The hospitalization expenses of the two groups were (25 466.00 ± 2 888.48) Yuan and (34 517.10 ± 4 948.39) Yuan respectively, and the difference was also statistically significant (P＜0.05). The incidence rates of portal thrombosis of the portal hypertension group and modified Sugiura operation group were 33.33% (12/36) and 40.00% (4/10), respectively, and the incidence rates of rehaemorrhagia of the two groups 12 months after the operation were 16.67% (6/36) and 10.00% (1/10), respectively, but the differences had no statistically significance (both P ＞ 0.05). In addition, 1 case with delayed gastric emptying and 1 case with stomal leak of esophagus happened in the modified Sugiura operation group, while no corresponding complications happened in the portal hypertension group.
Conclusions: Pericardial devascularization plus gastric fundus is a relatively easy procedure which has a good short-term clinical effect, and therefore it is suitable for application in primary hospitals. However, its long-term effect still needs further observation.
[摘要]目的 探讨贲门周围血管离断术加胃底血管横断术应用于晚期血吸虫病 (晚血) 门静脉高压症患者的效果。 方法 选择阳新县第三人民医院自2006年以来实施贲门周围血管离断加胃底血管横断术的36例晚血患者 (胃底血管横断 组), 以及同期采用改良Sugiura术进行治疗的10例晚血患者 (改良Sugiura组) 作为观察对象, 比较两类患者的临床疗 效。 结果 胃底血管横断组患者手术时间、胃管留置时间、术后进食时间、引流管拔除时间均短于改良Sugiura组, 差异 均有统计学意义 (P 均＜0.05), 两组住院费用分别为 (25 466.00 ± 2 888.48) 元和 (34 517.10 ± 4 948.39) 元, 差异亦有统计 学意义 (P ＜0.05)。术后胃底血管横断组和改良Sugiura组门静脉血栓发生率分别为33.33% (12/36) 和40.00% (4/10), 两 组术后12个月再出血发生率分别为16.67% (6/36) 和10.00% (1/10), 差异均无统计学意义 (P 均＞0.05); 改良Sugiura组出 现1例胃排空障碍和1例食管吻合口漏, 胃底血管横断组无相应并发症发生。 结论 贲门周围血管离断加胃底血管横断 术操作相对简单, 近期临床效果较好, 适用于基层医院, 但其远期效果还有待进一步观察。.
Keywords: Advanced schistosomiasis; Clinical effect; Gastric fundus transaction; Modified Sugiura operation; Pericardial devascularization; Portal hypertension.